Individual
JESSICA F WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
THE HOSPITAL OF CENTRAL CONNECTICUT OUTPATIENT CLINIC, 100 GRAND STREET, NEW BRITAIN, CT 06050
(860) 224-5261
(860) 224-5957
Mailing address
UCONN GRADUATE MEDICAL EDUCATION, 263 FARMINGTON AVENUE LM068, FARMINGTON, CT 06030-1921
(860) 679-4763
(860) 679-4624
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
07/23/2019
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